Loading...
HomeMy WebLinkAboutSIMPSON ELECTRIC INC - INSURANCE CERTIFICATE (7)SIMPELE-01 MMATHEWS ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �i 2/24/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER �NXM"E: mi ' Kurt Mann _ NAM TrueNorth PHONE 303 776-5122 F"' 303 776-5495 PO Box 847 _WC, No Exq: ( ) lac Nop ( ) Longmont, CO 80502 aoDaess: kmann@truenorthcompanies.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Charter Oak Fire Insurance Company 25615 INSURED INSURER B:Owners Insurance Company 32700 Simpson Electric, Inc INSURER C: Travelers Indemnity Company 25658 1920 Glenview Court INSURER D: Pinnacol Assurance Company 41190 Berthoud, CO 80513 INRIIRER I - rnvcRAncc CFRTIFICATE NUMBER_ REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR LTR TYPE OF INSURANCE ADDL lusn SUBRPOLICY WvD, POLICY NUMBER EFF MMIDDIYYYYI POLICY EXP 1MMIDDfYYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR 6803299C359 02/2012014 02/20I2015 EACH OCCURRENCE $ 1,000,00 uAMAGizi PREMISES Eaoocurrence $ 300,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ PRO JECT❑LOC OTHER: GENERAL AGGREGATE $ 2,000,00 2,000,00 E B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHALTEDULED AUTOS NON -OWNED X HIRED AUTOS X AUTOS I4268565900 11/24/2013 11/24/2014 Ee OMBIacccideMED SINGLE LIMIT E 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X UMBRELLALULB EXCESS LIAR X OCCUR CLAIMS -MADE N1A CUP8126C161 1495820 02/20/2014 04/01/2013 I 02/20/2015 04101/2014 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 DEC) I X I RETENTIONS 5,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ iOFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below X PER OTN- STATUTE ER $ E.L. EACH ACCIDENT $ 1,000+00 E.L. DISEASE -EA EMPLOYE E 1,000,00 E.L. DISEASE -POLICY LIMIT E 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS) VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) nvnrlI ^.= unl RCo CANCFI LATION rJCRIIrINMIL rIVLV L+\ ---- - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Laurie P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE 9069-- #Nall © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD PINNACOL ASSURANCE CITY OF FT. COLLINS, PURCHASING DIV P 0 BOX 580 FORT COLLINS CO 80522-0580 INSURED: Apex Sign Cc LLC dba Ad Light + Sign 4150 Elati St Denver. CO 80216 7501 E Lowry Blvd Denver, CO 80230-7006 Phone: (303) 361-4000 /(800) 873-7242 Fax: (303) 361-5000 / (888) 329-2251 www.pinnacol.com February 21, 2014 Policy #: 4030285 AGENT: Brown & Brown - Denver 1660 S. Albion Street Suite 525 Denver, CO 80222 (303)980-6265 Rescinding Pending Cancellation Notice To Certificate Holder The policy for: Policy #: 4030285 Insured: Apex Sign Co LLC dba Ad Light + Sign Lic is in good standing with Pinnacol Assurance. The February 18, 2014 notice of cancellation has been rescinded. As always, Pinnacol Assurance continues to be Colorado's premier workers' compensation insurance company. If you have any questions regarding this letter, or if I can be of further help, please contact me at the numbers listed below. Sincerely, Maria De Anda McCarthy, Underwriter Phone: (303) 361-4129 / (888) 852-2250 Fax: (303) 361-5100 / (888) 329-2206 Pinnacol Assurance' 7501 E Lowry Blvd' Denver, CO 80230 Page 1 of 1 UB402B- 02/211201419. 14:03 4030285 Updated 1211312006 P720